| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD SUITE 800 CONCORD, CA 94520 | BLUE CROSS OF CALIFORNIA | $117K | $4K | $121K | 2.70% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 2405 SATELLITE BLVD STE 200 DULUTH, GA 300969022 | PRINCIPAL LIFE INSURANCE COMPANY | $90K | — | $90K | 12.09% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA STREET SUITE 2400 SAN FRANCISCO, CA 941042215 | KAISER FOUNDATION HEALTH PLAN INC. | $22K | — | $22K | 4.76% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5666 CONCORD, CA 94524 | VISION SERVICE PLAN | $3K | — | $3K | 2.84% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 19000 MACARTHUR BLVD PENTHOUSE SUITE IRVINE, CA 92612 | AETNA LIFE INSURANCE COMPANY | $15K | — | $15K | 17.08% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | P.O. BOX 5668 CONCORD, CA 94524 | STANDARD INSURANCE COMPANY | $2K | $608 | $3K | 3.70% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | PO BOX 5666 CONCORD, CA 94524 | VISION SERVICE PLAN | $851 | — | $851 | 6.61% |
| MASOLI LEGACY LLC4 | 4319 BLENHEIM WAY CONCORD, CA 94521 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $1K | — | $1K | 16.27% |
| MARIAH L MASOLI4 Filed as: MARIAH L. MASOLI | 588 ALEXIS CIRCLE DALY CITY, CA 94014 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $81 | — | $81 | 0.96% |
| ZACHARIAH K MASOLI4 Filed as: ZACHARIAH K. MASOLI | 588 ALEXIS CIRCLE DALY CITY, CA 94014 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $45 | — | $45 | 0.53% |
| BLUMICIA BUSINESS SOLUTIONS4 | PMB271 3440 YOUNGFIELD STREET WHEAT RIDGE, CO 80033 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $30 | — | $30 | 0.35% |
| THE SAMSON GROUP4 | 18 GREENGATE COURT SANTA ROSA, CA 95409 | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | $28 | — | $28 | 0.33% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 1390 WILLOW PASS ROAD SUITE 800 CONCORD, CA 94520 | NATIONAL UNION FIRE INSURANCE CO. OF PITTSBURGH, PA | $318 | — | $318 | 14.98% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 209 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 418 | $5.0M |
| Dental(3 contracts, 3 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 328 | $904K |
| Vision(3 contracts, 2 carriers) | VISION SERVICE PLAN | 169 | $190K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 328 | $742K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 328 | $742K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 328 | $742K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 47 | $467K |
| Other(2 contracts, 2 carriers) | PRE-PAID LEGAL SERVICES INC. DBA LEGALSHIELD | 209 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 418 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.